Get Counseling Intake Form

Completing the Counseling Intake Form online can be a straightforward process if you follow the right steps. This guide will provide you with clear instructions on each component of the form, ensuring that you are able to submit your information accurately and efficiently.

Follow the steps to effectively complete your Counseling Intake Form online

1. Click the ‘Get Form’ button to obtain the Counseling Intake Form. This will allow you to open the document in your preferred editing software.
2. Begin by entering the date in the specified format (mm/dd/yyyy) at the top of the form.
3. Fill in your full name, including first, middle, and last names, and include the name you prefer to be called if different.
4. Provide your student ID and date of birth. Make sure to enter these details accurately.
5. You will find sections for your contact information. Fill in your home, cell, and work phone numbers. Indicate whether it's okay to contact you at each number.
6. Enter your email address only if you consent to receiving emails from the University Counseling & Consulting Services.
7. Complete your local address fields: street, city, state, and zip code. Also, indicate whether it is okay to contact you at your home.
8. Fill out your permanent address if it's different from your local address.
9. Identify an emergency contact by providing the name, relationship to you, and their telephone number.
10. Indicate how you learned about the University Counseling & Consulting Services by checking all that apply from the provided list.
11. In the Client Demographics section, provide your religious or spiritual affiliation, gender, sexual orientation, student status, college, current credit load, major, minor, and country of citizenship.
12. State your relationship status and ethnic background under the designated fields.
13. Reflect on your counseling history by stating whether you are currently seeing another counselor or therapist and providing relevant details if applicable.
14. Express your main reason for seeking counseling and list any additional significant concerns.
15. Clarify your goals for counseling by outlining what you hope to accomplish.
16. Describe your parental figures briefly, noting if they are living and their marital status.
17. Select the type(s) of individual counseling you desire and rank them by priority.
18. If applicable, indicate whether you are experiencing a crisis and provide details about its nature.
19. Assess your academic progress and note any barriers you are facing.
20. Complete any additional questionnaires or checklists related to personal, career, or academic concerns as instructed.
21. After filling out the form, review all provided information for accuracy. You can then choose to save changes, download, print, or share the form as needed.

Complete your Counseling Intake Form online today to take the first step towards receiving support.